Table 3.
Time intervals for breast cancer care-findings from the literature
| Country (region) | Year | n |
Total interval |
Patient interval |
Provider/system intervals |
||||||
| Definition | Median/ mean1 | > 3 mo (%) | Median/ mean1 | > 3 mo (%) | Reported interval | Definition | Median/ mean1 | > 3 mo (%) | |||
| High-income countries | |||||||||||
| Canada (Quebec)[105] | 1992-1998 | 29606 | - | - | - | - | - | Treatment | 1st diagnostic study to surgery. | 42 d | 17.1 |
| Canada[106] | 1996 | 4465 | - | - | - | - | - | Diagnosis | Abnormal screening to diagnosis | 31 d | - |
| France[30] | 2003 | 1494 | 1st abnormal screening to treatment start | 34 d | - | - | - | Diagnosis | Abnormal screening to diagnosis | 7 d | - |
| Treatment | Diagnosis to treatment start | 27 d | - | ||||||||
| Germany (Saarland)[11,107,108] | 1996-1998 | 380 | Symptom discovery or abnormal screening to diagnosis | - | 26.1 | 16 d | 17.4 | Provider | 1st consultation to treatment start | 15 d | 11.0 |
| Italy (Campania)[56] | 1998-1999 | 644 | Symptom discovery to surgery | - | 35 | - | 20 | - | 1st medical consultation to hospital admission | - | 11 |
| Italy (Campania and Apulia)[109] | 2004-2006 | 959 | - | - | - | - | - | Diagnosis | 1st consultation to diagnosis | - | 60 |
| Nether-lands[110] | 1996-2002 | 1503 | - | - | - | - | - | Diagnosis | Screening to diagnosis | - | 6.5 |
| North Ireland[91] | 2006 | 759 | - | - | - | - | - | Treatment | Diagnosis to treatment start | 15 d | - |
| Scotland[111] | 2005-2007 | 1250 | - | - | - | 7 d | - | Referral | 1st consultation to referral | 1 d | - |
| - | Specialist | Referral by GP to 1st consultation by specialist | 18 d | - | |||||||
| Spain (Catalonia)[112] | 2001-2002 | 266 | - | - | - | - | - | Treatment | Diagnosis to treatment start | 35 d | - |
| United Kingdom[113] | 1999-2000 | 25627 | Symptom discovery to diagnosis | 30 d | - | 9 d | - | - | GP referral to diagnosis | 11 d | - |
| United States[31] | 1991-1995 | 1659 | Abnormal screening to treatment start | 48 d | 22.9 | - | - | Diagnosis | 1st abnormal screening to diagnosis | 32 d | - |
| Treatment | Diagnosis to treatment start. | 10 d | - | ||||||||
| United States[54] | 1995-2005 | 246957 | - | - | - | - | - | Treatment | Diagnosis to treatment start | 23 d | - |
| United States (Califor-nia)[114] | 2003-2005 | 921 low income women | Symptom discovery to biopsy | 39 | - | - | - | - | - | - | |
| United States (North Carolina)[115] | 2000-2002 | 1786 | - | - | - | - | - | Treatment | Diagnosis to treatment start | 22 d | - |
| Middle-income countries: | |||||||||||
| Brazil (Brasilia)[25] | 2010 | 250 | Symptom discovery to treatment | 7.5 mo | 88.8 | - | 29.9 | Provider | 1st consultation to treatment start | - | 77.6 |
| Brazil (Rio)[24] | 2004 | 104 | Symptom discovery to diagnosis | 8 mo | - | 1 mo | - | Diagnosis | 1st consultation to diagnosis | 6.5 mo | 80 |
| Bulgaria[23] | 2011 | 448 | Symptom discovery to treatment | 3.9 mo1 | - | 1.2 mo1 | - | Provider | 1st consultation to treatment start | 3.1 mo1 | - |
| Colombia[95,116] | 2006-2007 | 852 | - | - | - | - | 20.3 | Provider | 1st consultation to treatment start | 4.5 mo | 31 |
| Croatia[23] | 2011 | 167 | Symptom discovery to treatment | 3.4 mo1 | - | 1.2 mo1 | Provider | 1st consultation to treatment start | 2.6 mo1 | - | |
| Egypt[29] | 2010 | 163 | - | - | - | 2.7 mo | - | - | 1st consultation to hospital arrival | 18 d | - |
| Ethiopia[117] | 2008 | 69 | - | - | - | 18 mo1 | - | - | - | - | - |
| Haiti[118] | 2012 | 90 | - | - | - | 1 wk | 42% | - | - | - | - |
| Hungary[23] | 2011 | 167 | Symptom discovery to treatment | 4.0 mo1 | - | 24 d1 | - | Provider | 1st consultation to treatment start | 3.6 mo1 | - |
| India[23] | 2011 | 207 | Symptom discovery to treatment | 7.4 mo1 | - | 1.5 mo1 | - | Provider | 1st consultation to treatment start | 6.2 mo1 | - |
| Iran[28] | 2000-2001 | 200 | - | - | - | 3 mo | 42.5 | - | - | - | - |
| Latvia[23] | 2011 | 111 | Symptom discovery to treatment | 4.4 mo1 | - | 1.5 mo1 | - | Provider | 1st consultation to treatment start | 3.3 mo1 | - |
| Libya[22] | 2008-2009 | 200 | Symptom discovery to diagnosis | - | 70.0 | - | 54.5 | - | - | - | - |
| Lithuania[23] | 2011 | 368 | Symptom discovery to treatment | 3.0 mo1 | - | 1.2 mo1 | - | Provider | 1st consultation to treatment start | 2.1 mo1 | - |
| Malaysia[26] | 2005-2007 | 328 | Symptom discovery to diagnosis | 5.5 mo | 72.6 | 2 mo | 43.3 | - | - | - | - |
| Mexico[34] | 2008 | 32 | Symptom discovery to treatment start | 7.5 mo | 10 d | Diagnosis | 1st consultation to diagnosis | 2.8 mo | |||
| Mexico[27] | 2010-2011 | 384 | Abnormal mammogram or symptom discovery to treatment start | 7.8 mo | 90.0 | 11 d | 20.6 | Provider | 1st consultation to treatment start | 4.7 mo | 73.7 |
| Nigeria[103] | 2009-2010 | 201 | - | - | - | - | 81 | - | - | - | - |
| Poland[23] | 2011 | 557 | Symptom discovery to treatment | 2.9 mo1 | - | 25 d1 | - | Provider | 1st consultation to treatment start | 2.4 mo1 | - |
| Romania[23] | 2011 | 271 | Symptom discovery to treatment | 6.4 mo1 | - | 1.5 mo1 | - | Provider | 1st consultation to treatment start | 7.4 mo1 | - |
| Russia[23] | 2011 | 718 | Symptom discovery to treatment | 3.9 mo1 | - | 1.2 mo1 | - | Provider | 1st consultation to treatment start | 3.1 mo1 | - |
| Slovakia[23] | 2011 | 154 | Symptom discovery to treatment | 3.3 mo1 | - | 1.0 mo1 | - | Provider | 1st consultation to treatment start | 2.7 mo1 | - |
| Serbia[23] | 2011 | 663 | Symptom discovery to treatment | 3.2 mo1 | - | 1.1 mo1 | - | Provider | 1st consultation to treatment start | 2.3 mo1 | - |
| Thailand[35] | 1994-1996 | 94 | - | - | - | 1 mo | 26.6 | Provider | 1st medical consultation to hospital admission | 1 mo | 24.4 |
| Thailand[36] | 2009 | 109 | - | - | - | 12 d | 17.0 | Provider | 1st consultation to treatment start | 21 d | 42.0 |
| Turkey[23] | 2011 | 694 | Symptom discovery to treatment | 3.4 mo1 | - | 1.2 mo1 | - | Provider | 1st consultation to treatment start | 2.6 mo1 | - |
1
These correspond to mean intervals, instead of medians. Patient interval is not defined in the table because studies coincide in the accepted definition: symptom discovery or abnormal screening to first medical consultation.